Key result
In two patients with anterior STEMI, precordial R-wave reappearance corresponded with better myocardial recovery and smaller infarct size on CMR compared to persistent R-wave loss.
Why the study?
Does precordial R-wave reappearance predict infarct size and myocardial recovery in patients after acute anterior STEMI?
Case Report (n=2)
No
Does precordial R-wave reappearance predict infarct size and myocardial recovery in patients after acute anterior STEMI?
Precordial R-wave reappearance after anterior STEMI treated with pPCI may serve as an early ECG marker for smaller infarct size and better myocardial recovery.
Hypothesis-generating for R-wave reappearance after anterior STEMI; prospective validation needed before clinical adoption.
Pathological Q waves may appear on the 12-lead electrocardiogram (ECG) during acute ST-segment elevation myocardial infarction (STEMI) and signify loss of electrical excitation. Anterior wall STEMI often results in loss of R waves in the precordial leads and subsequent appearance of pathological Q waves. Not infrequently, very early loss of R waves may be visible in patients presenting with anterior STEMI and occasionally, these R waves reappear in the first months following the index event. Despite reports in the literature [ 1 – 9 ], the prognostic significance of R-wave reappearance (RWR) in the setting of primary percutaneous coronary intervention (pPCI) remains uncertain. In this report we present two patients with anterior STEMI who underwent uncomplicated pPCI. The follow-up ECGs were indicative of the amount of myocardial recovery after the acute event as shown by cardiovascular magnetic resonance (CMR) imaging.
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Rijnierse et al. (2011) conducted a case report in Acute STEMI (n=2). Precordial R-wave reappearance vs. Persistent R-wave loss was evaluated on Myocardial recovery (infarct size and LVEF) assessed by CMR. In two patients with anterior STEMI, precordial R-wave reappearance corresponded with better myocardial recovery and smaller infarct size on CMR compared to persistent R-wave loss.
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